Dizzy, unsteady, nauseated? You may have vertigo, a false sensation of movement that affects more than 40 percent of people over age 40. The condition stems from problems in the inner ear or in the brain or spinal cord.
“Some people feel like they’re spinning,” says Ileana Showalter, MD, an ear, nose, and throat physician at Mercy Medical Center in Baltimore, Maryland. “Others feel like they’re moving in a boat. Most people describe vertigo as feeling dizzy, light-headed, and off-balance.”
Fortunately, you don’t have to live with vertigo. And the more you know about it, the better you can battle it. Below are surprising vertigo facts that may help you right your balancing act.
Vertigo is a symptom. Vertigo is not a diagnosis, says Showalter. Other conditions cause it. So, you have to figure out what lies behind yours. Possibilities include migraines; an inner ear tumor or inflammation; a stroke; multiple sclerosis; or Meniere’s disease, an inner ear disorder.
Vertigo has two types. Peripheral vertigo, which affects about 60 percent of people with vertigo, stems from problems in the parts of the inner ear that control balance. It may also involve the vestibular nerve, which connects the inner ear to the brain stem.
The other type is central vertigo caused by a brain problem usually in the brain stem or the cerebellum, the part of the brain that controls balance.
Age and vertigo are linked. “As we age, the connection between the inner ear and the parts of the brain that regulate that connection become less efficient,” says Showalter. “So, a huge proportion of [older] people suffer from dizziness.” Vision, muscles and bones—all of which help us stay in balance—also weaken. “If you have hip problems and your inner ear doesn’t function as well as it used to, both those can cause balance problems,” she explains.
Vertigo ranges in severity. “Some vertigos are incapacitating” says Showalter. “If you are falling and vomiting, you should get medical help right away.” That is also true if you have symptoms such as double vision, slurred speech, and lack of coordination. Says Showalter, “Those symptoms could point to a stroke.”
If you have mild to moderate vertigo that doesn’t clear up after a week or two, see your primary care doctor, recommends Showalter. Your doctor will likely give you an electrocardiogram (EKG) to rule out a heart condition, and a blood test to check for anemia or electrolyte imbalance. Electrolytes like sodium and potassium help regulate body systems that could affect balance.
“If the doctor finds those tests negative, he will refer you to a neurologist or an ear, nose, and throat doctor,” says Showalter.
Some medications can cause vertigo. “Any medication that affects the central nervous system”—brain, spinal cord, and nerves—“can cause dizziness,” says Showalter. Possible culprits may include sleep, anti-anxiety, and anti-psychotic medications. Mixing drugs with alcohol can also cause dizziness. “And severe use of alcohol can affect balance permanently,” she says. According to the National Institute on Alcohol Abuse and Alcoholism, women face greater health risks if they drink three or more drinks daily, and men if they drink four or more.
Treatments vary. You will likely receive diazepam (Valium) intravenously or in pill form, or meclizine (Antivert)in pill form to control the feeling that you are moving, says Showalter.
If you are nauseated and/or vomiting, your doctor may give you an anti-nausea medication such as ondansetron (Zofran) or prochlorperazine (Compazine), both available in tablet form.
Other treatments will depend on the cause of your vertigo, says Showalter. For instance, if you have a growth on the vestibular nerve, which connects inner ear balance and movement sensors to your brain, you may need surgery or radiation. If you have Meniere’s disease, you may be given diuretics—drugs that increase urination– and placed on a low-sodium diet to reduce fluid in your inner ear.
You can tamp down symptoms. Before you can get to a doctor, avoid bright lights and loud sounds, and stay still, if you can. “If you rise from sitting to standing, wait several seconds before you walk,” says Showalter. “That lets your system regain its balance.”
Some vertigo can resolve on its own. Although sometimes vertigo vanishes without treatment, don’t just live with it, says Showalter: “It’s not normal to be out of balance.”